[Screening and validation of pivotal genes in hepatitis B virus-associated hepatocellular carcinoma].

Objective: To screen the pivotal genes involved in the occurrence and development of HBV-associated HCC. Additionally, perform validation and biological function analysis to evaluate changes in the expression of pivotal genes and their prognostic value in patients with hepatocellular carcinoma. Methods: The GSE121248 gene expression profile data of HBV-HCC patients were searched and downloaded from the GEO database. The R language was used to compare the differences in gene expression between hepatocellular carcinoma and paracancerous tissues. KEGG and GO function enrichment analyses were performed on the differential genes. PPI plots and pivotal gene screening were carried out through online tools like STRING and Cytoscape software. 369 cases of hepatocellular carcinoma and 160 healthy controls in TCGA and GTEx were used as validation cohorts to verify the expression levels of the pivotal genes. A Kaplan-Meier plot was drawn to evaluate the prognostic value of the pivotal gene. Results: A total of 120 differentially expressed genes were screened, of which 89 were up-regulated and 31 were down-regulated. Differential genes were mainly enriched in the metabolic pathways related to retinol metabolism, cytochrome P450 metabolism, and the p53 signaling pathway. The top 10 differential genes were selected as pivotal genes by the Cytoscape plug-in cytoHubba. There were significant differences in the expression levels of four types of CCNB1, CDK1, RRM2, and TOP2A genes in the validation cohort. All four types of genes were up-regulated. Survival analysis showed that patients with elevated expression levels of four genes had a poorer prognosis, with statistical differences in results. Conclusion: Four types of genes, CCNB1, CDK1, RRM2, and TOP2A, have high expression levels in patients with HBV-HCC and are correlated to shorter survival times, making them a potential target for diagnosis, prognosis, and treatment.

[Clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis associated interstitial lung disease].

Objective: To analyze the clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 (anti-MDA5)-positive dermatomyositis associated interstitial lung disease (DM-ILD). Methods: The patients with MDA5+DM-ILD who were admitted to Department of Respiratory Medicine, Nanjing Drum Tower Hospital from January 2017 to March 2021 were enrolled. The clinical data and survival information were analyzed retrospectively. Patients were divided into survival group or death group, and rapid progressive ILD (RP-ILD) group or non-rapid progressive ILD group, according to their survival status and clinical progression. Results: A total of 105 patients with anti-MDA5+DM-ILD (median age of onset 54 years) were enrolled, 58% being female (61 cases). The main sub-type of dermatomyositis was amyopathic dermatomyositis (n=74, 70%), followed by dermatomyositis (n=31, 30%). The main extrapulmonary manifestations were skin lesions (n=60, 57.1%), muscle manifestations(n=20, 19%) and arthralgia/arthritis (n=20, 19%). 15.4% of the patients had positive ANA (antibody titer≥1∶320), and 61.9% of the patients had anti-RO-52 kDa antibody. A total of 66 patients (62.8%) developed RP-ILD, and 58 patients (56.3%) died. Lower oxygenation index (OR=0.974, 95%CI:0.954-0.994, P=0.012) and no joint pain (OR=0.032, 95%CI: 0.002-0.663 P=0.026) were independent risk factors for RP-ILD. Cox regression analysis showed that RP-ILD (HR=3.194, 95%CI:1.025-9.954, P=0.045), older than 53 years (HR=3.450, 95%CI: 1.388-8.577, P=0.008), ferritin level more than 1 330.5 ng/ml (HR=3.032, 95%CI 1.208-7.610, P=0.018) and C-reactive protein (CRP) above 16.95 mg/L (HR=2.794, 95%CI:1.102-7.084, P=0.030) were independent predictors of mortality. Conclusions: The clinical manifestations of patients with anti-MDA5+DM-ILD presenting to the respiratory department were heterogeneous, with most being amyopathic dermatomyositis, and both the incidence of RP-ILD and the risk of death were high. Even in the absence of associated rash, joint, or muscle manifestations, anti-MDA5 antibody screening should be considered in patients with rapidly progressive ILD who were negative on baseline autoantibody screening but positive for anti-RO52kDa antibody.

Secular trends of incidence and hospitalization cost of hip fracture in Tangshan, China.

We investigated the secular trends of the incidence and hospitalization cost of hip fracture in Tangshan, China. The incidence of hip fracture and the hospitalization cost were both increasing during the observation period. INTRODUCTION: The present study aimed to determine sex-, age-, and fracture type-specific incidence and annual changes in hip fractures in Tangshan, China, between 2007 and 2018. METHODS: We analyzed annual hip fracture incidence using urban hospital data during 2007-2018 and calculated incidence rate/100,000 person years in each age group and sex. We assessed annual changes in incidence among people aged >60 years using linear-by-linear association tests and evaluated hospitalization costs with the Kruskal-Wallis test. RESULTS: During the study period, we observed an increasing proportion of hip fractures in people >60 years old from 14.2 to 22.79%. Crude hip fracture incidence increased markedly from 140.87 to 306.56/100,000 in women (p < 0.01) and from 124.83 to 167.19/100,000 in men (p < 0.01) in the age group >60 years. Type-specific analysis indicated significantly increased trends in incidence of cervical and trochanteric fractures among women and cervical fracture among men (p < 0.01). In people aged 36-60 years, the trend of hip fracture increased significantly in both sexes. The total and cervical-to-trochanteric ratio in men increased, with significant upward trends (p < 0.01). The proportion of cervical fracture was higher than that for trochanteric fracture in women, with stable levels from 2007 to 2018. Hospitalization costs for cervical and trochanteric fractures increased by 51.91% and 53.20%, respectively, during 2011-2018. CONCLUSION: Tangshan will have an increasing burden on health care resources attributable to a considerable rise in hip fracture incidence and the older population. Further investigation of risk factors and subsequent implementation of effective measures to prevent hip fracture are needed.

[Palmitoylome profiling indicates that androgens promote the palmitoylation of metabolism-related proteins in prostate cancer-derived LNCaP cells].

OBJECTIVE: To explore potential therapeutic targets other than androgen-deprivation treatment for prostate cancer by screening the proteins induced by androgen at palmitoylation modification level in LNCaP cells. METHODS: The LNCaP cells were treated with androgen (Methyltrienolone, R1881, 5 nmol/L) or dimethyl sulfoxide (DMSO) for 24 h, and then labeled with alkynyl palmitic acid Alk-C16 (100 µmol/L). After that, the cells were collected, lysed, the total protein was extracted, agarose beads labeled with azide (1 mmol/L) were added, and the click-chemistry reaction was carried out at room temperature for 1 h. The covalent bond formed by click-chemistry reaction of azide and alkynyl group was used to enrich the palmitoylated proteins on agarose beads. Label-free quantitation (LFQ) was used to compare the protein palmitoylation level of R1881 treated and untreated cells to screen the proteins induced by androgen at palmitoylation modification level. RESULTS: In this experiment, 907 potential palmitoylated proteins (mascot score>2, P<0.05) were identified, among which 430 proteins had LFQ values not zero at least twice. Among the 430 proteins, the palmitoylation levels of 92 candidates were increased by androgen treatment, and their LFQ values were significantly upregulated (>1.5-fold, P<0.05) in ≥2 samples of androgen-treated vs. untreated LNCaP cells. We also used the software of cytoscape to classify the 92 proteins, and found that the known functional proteins of them could be divided into three categories: metabolism related, protein folding related and translation initiation related. Among them, metabolism related proteins included lipid metabolism (6), glucose metabolism (7) and respiratory electron transport chain (8), and a small amount of amino acid metabolism (2) and other metabolism related proteins (2). Notably, the ratio of LFQ of cytochrome b-c1 complex subunit 2 (UQCRC2) was significantly (>3-fold, P<0.05) higher in androgen-treated cells compared with untreated cells, indicating that the palmitoylation level of UQCRC2 was enhanced by androgen most significantly than that of others. The second was long-chain acyl CoA dehydrogenase (ACADVL) related to lipid metabolism and glucose 6-phosphate dehydrogenase (PGD) related to glucose metabolism, but the LFQ ratio of them was less than 3-fold. CONCLUSION: The research on palmitoylation mechanism of metabolism, especially the proteins related to respiratory electron transport chain, will provide a new guidance for the diagnosis and treatment of prostate cancer and the development of targeted drugs.

[The outcome of trial of labor after cesarean section].

Objective: To explore the outcome of trial of labor after cesarean section(TOLAC). Methods: Totally 614 TOLAC were conducted in the First Affiliated Hospital of Kunming Medical University from July 2013 to June 2016. Among them, 586 cases of singleton pregnancy with one prior cesarean section(gestational age≥28 weeks)were studied retrospectively. The maternal and neonatal outcomes among the vaginal birth after cesarean(VBAC)group(481 cases), failed TOLAC group(105 cases)and the elective repeat cesarean section(ERCS)group(1 145 cases)were compared. Multiple logistic regression was used to determine the risk factors of admission to neonatal intensive care unit(NICU). Results: (1)The TOLAC rate was 29.62%(614/2 073)from July 2013 to June 2016, and the VBAC rate was 82.6%(507/614). The cesarean section rate was reduced by VBAC by 3.147%(507/16 112).(2)The comparison of adverse maternal outcomes: in the VBAC group, the postpartum hemorrhage volume was(431±299)ml, the rate of postpartum fever was 6.4%(31/481), the birth weight of the neonates was(3 085± 561)g, and the rate of large for gestational age was 2.9%(14/481). All were significantly lower than those in the failed TOLAC group and the ERCS group(P<0.05). There was no significant difference in other adverse maternal outcomes[the uterine rupture rate(0.2% ,1/481), the bladder injury rate(0), the proportion of postpartum hemorrhage volume≥1 500 ml(1.0%, 5/481), the blood transfusion rate(3.7%, 18/481)]and adverse perinatal outcomes[the rate of neonatal 5-minute Apgar score<7(0.4%, 21/481), the rate of umbilical arterial pH<7.0(0.6% , 3/481), the rate of the NICU admission and the perinatal mortality rate(12.3%, 59/481)]among the 3 groups(P>0.05). Multiple logistic regression showed no association between VBAC and admission to the NICU(OR=0.84, 95%CI: 0.58-1.21). The isolated risk factors for admission to the NICU were preterm birth(OR=16.71, 95% CI: 11.44-24.40), hypertensive disorder complicating pregnamcy(OR=3.89, 95% CI: 2.39-6.35), meconium stained amniotic fluid(OR=2.48, 95% CI: 1.62-3.80), small for gestational age(OR=2.00, 95% CI: 1.19-3.36)and diabetes mellitus(OR=1.69, 95% CI: 1.14-2.50). Conclusions: VBAC reduces cesarean section rate, with good outcomes in both mother and neonate. It is a safe and feasible way of labor in women with only one cesarean section history.

DUXAP8 promotes the proliferation and migration of ovarian cancer cells via down-regulating microRNA-29a-3p expression.

OBJECTIVE: To study the role of long-chain non-coding RNA (lncRNA) DUXAP8 in ovarian cancer (OCa) and the underlying potential mechanism. PATIENTS AND METHODS: The expression pattern of DUXAP8 in ovarian cancer was analyzed using the GEPIA database. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to determine the expression of DUXAP8 in OCa tissues; at the same time, OCa cell lines were cultured to complete functional experiments, including cell counting kit-8 (CCK-8), plate cloning experiments and transwell experiments to evaluate the effects of DUXAP8 on the proliferative and migration ability of OCa cell lines. Bioinformatics analysis and Dual-Luciferase reporter genes were used to determine the binding and expression of DUXAP8 to its downstream key gene microRNA-29a-3p in OCa cells. In addition, co-transfection technology and cell function recovery experiments were used to verify the important role of the DUXAP8/microRNA-29a-3p regulatory network in OCa. RESULTS: DUXAP8 was abnormally highly up-regulated in OCa tissues and cell lines, besides, its expression was related to poor prognosis of patients. CCK-8 and plate cloning experiments showed that knockdown of DUXAP8 in OCa cells can significantly inhibit the proliferation of OCa cells. Transwell results suggested that knockdown of DUXAP8 can significantly inhibit OCa cell migration. In addition, it was found that DUXAP8 can bind and negatively regulate the expression of microRNA-29a-3p in OCa. Functional experiments in OCa cells also revealed that microRNA-29a-3p was a key downstream gene that mediated the regulation of DUXAP8 on OCa function. CONCLUSIONS: DUXAP8 has abnormally high expression in OCa and can lead to malignant progression of the tumor.

[Two cases report of laryngeal malignant melanoma and a review of literatures].

Summary Two patients both complained of one year history of hoarseness and the clinical manifestations and imageology among 2 patients were lack of specificity. The pathological tissue was successfully eradicated by surgical removal. Histopathology established laryngeal malignant melanoma as the diagnosis. The clinical manifestations and imageology were lack specificity between laryngeal malignant melanoma, laryngeal cancer and other malignant tumor, the diagnosis is difficult, often confirmed by postoperative pathology, the treatment is often by surgery and have a poor prognosis.

Early third trimester maternal response to glucose challenge and pregnancy outcome in Chinese women-relationship between upper distribution level and recommended diagnostic criteria.

BACKGROUND/OBJECTIVES: The objective of this study was to examine the relationship between upper distribution levels of glucose values in the 75-g oral glucose tolerance test (OGTT) and recommended diagnostic criteria for gestational diabetes mellitus (GDM) and adverse pregnancy outcomes. SUBJECTS/METHODS: The distribution of the OGTT 2-h values of 13,501 pregnant women, which were below the World Health Organization (WHO) threshold for overt diabetes mellitus (DM), and managed in one teaching hospital in China, was reviewed and related to maternal characteristics and pregnancy outcomes. RESULTS: For the entire group, the 90th and 95th percentile values of the OGTT 2-h glucose level, respectively, were close to the diagnostic cutoff values of the WHO and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. For adverse maternal outcomes, glucose level above the 90th percentile value was associated with increased hypertensive disorders, whereas no difference was seen with cutoff using the 95th percentile value. For perinatal outcomes, the 90th percentile was associated with increased neonatal intensive care unit admission and hypoglycemia, whereas the 95th percentile showed in addition association with phototherapy for jaundice and 5th-minute Apgar score <7. Although no differences in the incidence of adverse pregnancy outcomes were found using the different cutoffs, the >95th percentile cutoff value would have missed out 33.3-56.7% of the cases of adverse outcomes that would otherwise have been attributed to GDM. CONCLUSIONS: Further studies are warranted to clarify which diagnostic criterion is most appropriate universally to identify adverse pregnancy outcomes attributed to GDM, and which could be mitigated with treatment specific for GDM.

Microinvasive Nd:YAG laser therapy of early glottic carcinoma and its effect on soluble interleukin-2 receptor, interleukin-2, and natural killer cells.

OBJECTIVE: To investigate the effectiveness of microinvasive Nd:YAG laser therapy in human glottic Tis and T1 carcinomas, as well as its effect on the cellular immune function of the tumor-bearing hosts. STUDY DESIGN: We treated 34 patients with microinvasive Nd:YAG laser therapy and evaluated its effect on the cellular immune function of the host. METHODS: Thirty-four patients with glottic Tis or T1 squamous cell carcinoma were treated with fiberoptic laryngoscopic Nd:YAG laser surgery. Both before and after therapy, serum levels of soluble interleukin-2 receptor (SIL-2R) and interleukin-2 (IL-2), as well as natural killer (NK) cell activity, were determined by means of double-antibody sandwich technique, tritiated thymidine-deoxyribonucleoside incorporation, and iodine 125-uridine-deoxyribonucleoside release technique, respectively. RESULTS: All 34 patients tolerated the procedure well. A 3- to 7-year follow-up in a subgroup of 27 patients resulted in an estimated cure rate of 85.2% (23 of 27 patients). In all 27 patients with a regular follow-up, a subjective improvement of phonation was noted after therapy to various degrees. In 74% (20 of 27 patients), voice and speech subjectively recovered to almost normal levels. The post-therapy serum levels of SIL-2R were significantly declined (P <.001), whereas those of IL-2 and the NK activity were significantly elevated (P <.001) as compared with those detected before therapy. CONCLUSIONS: Therapy with fiberoptic laryngoscopic Nd:YAG laser surgery is simple, safe, effective and only minimally invasive for patients with glottic Tis or T1 carcinoma. At the same time, it has an immunoenhancing effect on its host.

A comparison of 99Tcm-MIBI myocardial SPET and electron beam computed tomography in the assessment of coronary artery disease in two different age groups.

The aim of this study was to compare the clinical value of 99Tcm-MIBI single photon emission tomography (SPET) and electron beam computed tomography (EBCT) in the assessment of coronary artery disease (CAD) in different age groups. 99Tcm-MIBI SPET (stress-rest), EBCT and coronary angiography studies were performed in 64 consecutive patients with suspected CAD. The patients were classified into two groups: Group A = 40 patients > 45 years of age and Group B = 24 patients < or = 45 years of age. There were 31 and 14 patients with coronary stenosis > or = 50% as determined by coronary angiography in Groups A and B, respectively. All patients (30 cases) with abnormal 99Tcm-MIBI myocardial SPET and coronary calcification detected by EBCT had significant coronary artery disease, and 93.3% of the patients with normal 99Tcm-MIBI SPET and normal EBCT had normal coronary angiography or < 50% lumen narrowing of the coronary arteries. In Group B, the sensitivity of SPET for detecting CAD was significantly higher than that of EBCT (92.9 vs 42.9%, P < 0.01); the specificity of SPET was comparable to that of EBCT. In Group A, there was no significant difference between SPET and EBCT in terms of sensitivity (93.6 vs 90.3%) or specificity (88.9 vs 55.6%). However, in the detection of individual coronary artery disease, the specificity of SPET was significantly higher than that of EBCT in Group A (94.1 vs 66.7%, P < 0.001). The sensitivity of SPET was again significantly higher than that of EBCT (85.7 vs 38.1%, P < 0.005) in Group B. The accuracy of SPET was higher than that of EBCT in both groups (82.5 vs 67.5%, P < 0.01 in Group A; 93.1 vs 76.4%, P < 0.01 in Group B, respectively). We conclude that 99Tcm-MIBI myocardial perfusion SPET has a higher sensitivity than EBCT in the detection of CAD in patients < or = 45 years old and a higher specificity in patients > 45 years of age. A combination of SPET and EBCT may assess CAD more accurately.

Effect of photodynamic therapy on selected laboratory values of patients with nasopharyngeal carcinoma.

We determined pre- and post-photodynamic therapy (PDT) serum levels of soluble interleukin-2 receptor (SIL-2R) and interleukin-2 (IL-2), as well as activity of natural killer (NK) cells, among 24 patients with either persistent or recurrent nasopharyngeal carcinoma (NPC), using a double-antibody sandwich technique, tritiated thymidine-deoxyribonucleoside incorporation, and iodine 125-uridine-deoxyribonucleoside release techniques, respectively. The results showed that the post-PDT serum level of SIL-2R had significantly declined (p < .0005), while that of IL-2 and the NK cell activity had significantly increased (p < .0005), compared with pre-PDT values, suggesting an immunoenhancing effect of PDT on NPC patients.

[Cloning and function of sanJ--a gene involved in nikkomycins biosynthesis of Streptomyces ansochromogenes].

A 7.5 kb DNA fragment was identified from the cosmid library of Streptomyces ansochromogenesus using a partial DNA fragment involved in the nikkomycin biosynthesis as a probe. It was cloned into pBluescript M13- and the resulting recombinant plasmid was designated as pNL2200. The nucleotide sequence of 2.3 kb Sal I -BamH I DNA fragment was determined and analysed. The result indicated that the fragment contains one complete open reading frame (ORF); The start codon is GTG at 271 position and the stop codon is TGA at 1,954 position. It contains 1,686 base pairs and encodes a protein with 561 amino acids. The deduced product has 44% identity with the ligase belong to the superfamily of adenylate-forming enzyme. The experiment of gene disruption showed that the sanJ gene was closely related to nikkomycins biosynthesis of Streptomyces ansochromogenes. It was designated as sanJ.

[Genital condyloma acuminata: report of 63 cases].

Sixty-three cases of condyloma acuminata were treated from Aug. 1986 to May 1989. There were 44 males and 19 females. The age ranged from 17 to 55. The illness is a sexually transmitted disease. The etiology, diagnosis, management and prognosis were discussed.

[Development of a multi-channel physiological telemetry system].

OBJECTIVE: To develop an instrument used in measurement of physiological parameters in laboratories or field. Method A: computer was used to process data in the telemetry system. The frequency-time division modulation technique was adopted. The low frequency signals were directly connected to the computer serial port after demodulation, and measurement control was achieved by single-chip computer. Temperature measurement results were obtained by conversion table. RESULT: It is capable of telemeter and processing ECG, wind speed and temperature signals in real-time. Good results were gained in high temperature condition and -17 degrees C environment. CONCLUSION: The instrument has many advantages, such as high accuracy, good processing ability, reliability, long operation distance, small volume and easy operation.

[Research on automatic diagnosis system of electrocardiogram].

The duration of QRS wave, P wave and T wave of ECG can be computerized and auto-detected with digital signal process and wave recognition technology. It can diagnose 15 kinds of abnormal ECG such as ventricular presystole automatically and print out corresponding diagnosis reports. In order to verify the system's stability and creditability, we used American MIT-BIH database to test our algorithms and got a good result.

[MDM2 gene amplification and overexpression in nasopharyngeal carcinoma].

MDM2 gene amplification and overexpression were detected by DNA dot blot analysis and reverse transcription-polymerase chain reaction (RT-PCR) in 32 cases of nasopharyngeal carcinoma (NPC), 10 cases of chronic inflammation of nasopharyngeal epithelium(CINE) and NPC cell line HONE1. One case of NPC showed MDM2 gene amplification, NPC cell line HONE1 and ten cases of NPC showed MDM2 mRNA overexpression. No MDM2 gene amplification and overexpression were found in CINE. MDM2 mRNA overexpression was significantly related to cervical lymph node metastasis, but not to T stage of NPC. The results indicate that MDM2 gene may play an important role in the pathogenesis and the process of metastasis of NPC.

[MDM2 gene expression in nasopharyngeal carcinoma and its relationship with p53 protein expression and EB virus latent infection].

OBJECTIVE: To define the expression levels of MDM2 gene in nasopharyngeal carcinoma (NPC) and its relationship with p53 protein expression and EB virus latent infection. METHOD: MDM2 gene expression at mRNA and protein levels, p53 protein and EB virus DNA were detected by nonradioactive in situ hybridization (ISH), immunohistochemistry(IHC) and polymerase chain reaction (PCR) separately in 46 cases of NPC tissues and 12 cases of chronic inflammation of nasopharyngeal epithelium (CINE). RESULT: Fourteen cases of NPC showed MDM2 mRNA and protein overexpression, 38 cases were p53 protein positive, and 43 cases were EBV-DNA positive. Neither MDM2 nor p53 protein was expressed in any case of CINE. MDM2 expression was significantly related to p53 protein expression (P < 0.05), but not to EB virus latent infection in NPC. CONCLUSION: MDM2 gene may play an important role in the pathogenesis of NPC through interacting with p53 protein.